Part 5: Sleep Medicine for the Neurologist

Question 2

A 20-year-old college student presents with complaints of excessive daytime sleepiness (EDS) for the last 2 years that has progressively worsened and has resulted in her missing several morning classes because she sleeps through her alarm clock. She denies experiencing episodes of loss of muscle tone in the context of strong emotion such as laughter and denies seeing things as she falls to sleep. She reports no problem with sleep once she goes to bed, although she reports 2 episodes in the last 2 years that are consistent with sleep paralysis. She reports a variable bedtime, and after further discussion describes herself as being a “night-owl.” She denies snoring or difficulty breathing while she sleeps. What would be the most appropriate next step in her evaluation?